Estrogen replacement therapy doesn't help heart disease.

THE STUDY AND RESULTS Researchers at six sites around the country studied more than 300 post-menopausal women with heart disease. The women were randomly assigned to receive either pills containing the female sex hormone estrogen, estrogen plus progesterone or a sham medication. The women were followed for an average of more than three years. The researchers found that the women on both types of estrogen replacement had significant reductions in their low-density lipoprotein (the bad cholesterol) and improvements in their high-density lipoprotein (the good cholesterol). However, angiograms of the women showed that none of the groups had altered the progression of the disease in the coronary arteries.

WHAT'S NEW Some details of this study were reported earlier in the year at a scientific meeting, but this is the first time that the complete study has been published. Other studies have been inconsistent on this subject. This is one of the longer-term studies that looks at the effect of estrogen and estrogen plus progesterone on women who already have heart disease and it found that estrogen alone was not any more effective than estrogen plus progesterone.

CAVEATS The hormone replacement therapy was initiated late in these women--an average of 23 years after menopause. The study involved only women already diagnosed with heart disease and therefore does not tackle the question of whether hormone replacement therapy is beneficial as a preventive to heart disease.

BOTTOM LINE Women with heart disease may not want to start hormone replacement therapy as a treatment for their disease.

FIND THIS STUDY Aug. 24 issue of the New England Journal of Medicine; abstract online at www.nejm.org.

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